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Impact of Lung Function and SDB on Incident Myocardial Infarction and Heart Failure: A Community-based Study

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Abstract

Purpose

To investigate whether lung function, especially when complicated with SDB, has an increased risk for myocardial infarction (MI) and congestive heart failure (CHF).

Methods

A prospective study was performed within the Sleep Heart Health Study (SHHS). A total of 4161 individuals were followed up for an average of 10.91 years. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and the predicted value of FVC and FEV1 were measured to evaluate lung function. The primary outcomes were the MI and CHF. Cox regression analysis was used to investigate the association between reduced lung function and the incidence of MI or CHF. In subgroup analysis, all the individuals were divided into Apnoea–Hypopnoea Index (AHI) < 5 subgroup and AHI ≥ 5 subgroup to explore the relationship.

Results

Lung function were inversely associated with the incidence of MI or CHF. The hazard ratio (HR) and 95% confidence interval (95% CI) for MI and CHF were 0.658 (0.543–0.797) and 0.792 (0.673–0.933) for every 1 L increase in FVC, 0.715 (0.567–0.902) and 0.738 (0.605–0.900) for every 1 L increase in FEV1, 0.986 (0.979–0.993) and 0.989 (0.983–0.995) for every 1% increase in FEV1/pre%, and 0.994 (0.988–0.999) and 0.991 (0.987–0.996) in FVC/pre%, respectively. In addition, the association of lung function with MI and CHF was more prominent in the subgroup with AHI ≥ 5.

Conclusions

Lung function may be associated with incident MI and CHF in this large community cohort of middle-aged and older adults, especially in those with SDB.

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Acknowledgements

We appreciate the Brigham and Women’s Hospital for sharing the Datasets of Sleep Heart Health Study (SHHS). Besides, SHHS acknowledges the Atherosclerosis Risk in Communities Study, the Cardiovascular Health Study, the Framingham Offspring and Omni Study, the Strong Heart Study, Tucson Epidemiological Study of Obstructive Lung Disease, the cohort studies of respiratory disease in Tucson, and cohort studies of hypertension in New York. SHHS is particularly grateful to the members of these cohorts who agreed to participate in SHHS as well. SHHS further recognizes all of the investigators and staff who have contributed to its success. A list of SHHS investigators, staff and their participating institutions is available on the SHHS website, https://sleepdata.org/datasets/shhs.

Funding

This study was supported by National Natural Science Foundation of China (Grant No. 81770057).

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Authors and Affiliations

  1. Department of Critical Care Medicine, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

    Ruohan Li, Jingjing Zhang, Ya Gao, Jiamei Li & Gang Wang

  2. Department of Clinical Research Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

    Bin Yan

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  1. Ruohan Li
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Correspondence to Gang Wang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Li, R., Zhang, J., Gao, Y. et al. Impact of Lung Function and SDB on Incident Myocardial Infarction and Heart Failure: A Community-based Study. Lung 197, 339–347 (2019). https://doi.org/10.1007/s00408-019-00229-0

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  • DOI: https://doi.org/10.1007/s00408-019-00229-0

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